Integrated Team Approaches To Improving Outcomes For Chronic Pain


In early September, Samueli Institute convened more than 40 leaders in pain management as part of the Chronic Pain Breakthrough Collaborative. The meeting was the second of three highly interactive learning sessions focused on state-of-the-art ideas in integrative chronic pain care.  Participants shared with each other the specific best practices they’ve tried – what worked and what didn’t – and learned how to customize recommended ideas to accelerate improvement in their own organizations.

Participants included military and civilian health system practitioners, from senior health system leaders, physicians, anesthesiologists and surgeons to social workers, acupuncturists, physical therapists, and process improvement specialists, all dedicated to providing better care for patients who suffer from chronic pain.


Dr. Paul Mittman

“When Samueli Institute partnered with the Institute for Healthcare Improvement (IHI), it was really a brilliant marriage in that they took a conceptual framework of using this rapid cycle of change that they call Plan Do Study Act (PDSA) and gave us an opportunity to make big changes, but starting with little bite-size changes that we do over and over again.” Paul Mittman, ND, President/CEO of Southwest College of Naturopathic Medicine & Health Sciences.

This learning session offered the opportunity for participants to share what results they’re experiencing at their hospitals, institutions, or clinics as a result of their Collaborative participation. During the time between the first and second learning sessions, using the PDSA process, participants developed a plan to test possible changes for their organization, carried out the test, and then observed the results.

The teams have concentrated on making improvements in four areas:

1) increasing autonomy for individuals to manage their pain through non-pharmacological approaches;

2) integration of multiple disciplines in team-based approaches;

3) increasing quality of life through decreasing the level of pain, medication burden, and risk of opioid dependence; and

4) building a sustainable business model that provides positive or neutral financial impact over time. These improvements are adding up to a sustainable business model for the future.

For Dr. Mittman, collaborating with like-minded physicians was an inspiring experience that he and his participating colleagues took back with them to SCNM’s pain relief center.

“Just bringing three people with very different backgrounds, let’s say an acupuncturist, a medical doctor and a naturopathic doctor and putting them in the same place doesn’t guarantee that you have a team,” Mittman explained. But by participating in the learning collaborative his staff has, “developed into a cohesive team.”

And the teamwork is already having a positive effect.

“Our anesthesiologist has observed a decrease in opioid use in his patients, which is really interesting because that’s without fully implementing the program,” Mittman explained. “I think the awareness of the problem and by beginning to implement new solutions to it you can start to see subtle changes—and we’re starting to see that already.”
Samueli Institute is currently seeking participants for the next learning community on chronic pain. Learn more about our Chronic Pain Breakthrough Collaborative.